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What Is Eczema?
Eczema is a chronic, non-infectious, inflammatory skin condition characterized by an itchy rash. It affects around 15% of children but most grow out of it and only 2-4% of adults have it. When they do however, adults tend to experience the more severe kind.
People who have eczema tend to experience phases of more and less severe symptoms. Acute flare-ups can have a marked negative impact on quality of life. Extreme itching can make concentrating and sleeping very difficult, while visible rashes can lead to embarrassment. However, if you take good care of your skin and avoid triggers, it is usually possible to live a fairly normal life.
For those interested in seeing images of eczema, check out this link by WebMD: A Visual Guide To Eczema. But bear in mind that the images are graphic and may require a strong stomach.
What Are The Symptoms Of Eczema?
Eczema tends to come and go in bouts. During a flare-up skin can become red and itchy - where itching is the main symptom and can often be unbearable - and sometimes develop blisters that break and weep. Over time skin may thicken and become dry, cracked and rough.
What Is The Difference Between Eczema And Dermatitis?
Dermatitis and eczema are both terms for inflammation of the skin characterized by red, dry patches and rashes. The terms are often used interchangeably and there is an overlap. Some specific conditions however, are known better by just one of the two names. Eczema and atopic dermatitis, for instance, are used interchangeably, but doctors generally don't substitute contact dermatitis for eczema and vice versa.
Several different types of eczema and dermatitis exist, and it is possible to have more than one type at the same time. Some forms also cause blistering and peeling and most forms are chronic. Contact dermatitis is an exception that is caused by an allergic reaction to an irritant and can be prevented avoiding the irritant.
The Different Types Of Eczema And Dermatitis
Atopic Dermatitis Or Eczema
This tends to be chronic and is characterized by an itchy, red rash. It usually appears around the joints and the neck. It tends to occur in bouts and symptoms include dry skin, flaky or scaly patches, itching, and less commonly, weeping sores.
Contact Dermatitis
Contact dermatitis is an allergic reaction to an irritant. Symptoms include a red rash that may itch, burn or sting. You may also develop liquid-filled blisters.
Seborrheic Dermatitis
This commonly affects areas with high sebaceous gland density such as the scalp, and is also known as dandruff. It has a scaly, dry appearance and may be caused by a reaction to the malassezia fungus that lives on your skin. Other symptoms include redness and rashes. It is also known as seborrhoea, cradle cap, sebopsoriasis, and pityriasis capitis.
Perioral Dermatitis
This is a rash in which bumps develop around the mouth. It is worth mentioning here as it has become more common with the rising use of face masks. If there's no infection, the simplest course of treatment involves being gentle with your skin to avoid further irritation and to allow the skin barrier to rebuild. You can do this by using a gentle cleanser, such as our Hydrating Gentle Daily Cleanser, and a moisturiser designed for irritated and sensitive skin, such as our Million Dollar Moisturiser.
Other Types Of Eczema And Dermatitis
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dyshidrotic eczema
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nummular eczema
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follicular eczema
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stasis dermatitis (varicose eczema, gravitational eczema)
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hand eczema
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dermatitis herpetiformis
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pompholyx eczema
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neurodermatitis
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discoid eczema
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asteatotic eczema (eczema cracquelée)
What Causes Eczema?
Our skin has layers of which the outermost is called the epidermis. The epidermis is further subdivided and its outermost layer is called the stratum corneum. This is the visible part of the skin that protects the body from the outside world. The epidermis renews itself constantly as new cells from the lowest layer make their way up to the surface and dead cells are shed off.
In people with eczema, the stratum corneum is damaged by an immune response and is unable to provide sufficient protection from external stressors such as irritants, allergens and germs. Eczema is also possibly caused by a mutation in the gene responsible for filaggrin production, where filaggrin is an essential protein that decomposes to form the skin’s natural moisturising factor (NMF). This results in a poorly formed stratum corneum that is more prone to water loss and more permeable to irritants that can illicit an immune response.
30-40% of people who have eczema have an allergic type and also tend to have other more severe skin problems, hay fever and allergic asthma. Their immune system has a tendency to overreact to allergens such as dust mites and pollen, and certain foods such as milk, eggs, nuts and fish. Blood tests that can detect antibodies in the blood are able to diagnose these allergies.
While genes play a major role in the development of eczema, some external factors are thought to be at play as well. These include pollution and increased hygiene - based on the observation that children with several siblings, or a dog, have a lower probability of developing eczema. This is possibly because they are exposed to germs at an earlier age resulting in a better trained immune system.
The skin can also be irritated by non-allergenic environmental factors such as rough fabrics, cigarette smoke and extremes in temperature.
Other Effects Of Eczema
Staphylococcus aureus is a type of bacteria that is commonly found on human skin. While usually harmless, it thrives on broken skin and can cause an infections in eczema skin making the condition worse. Staph infections - characterised by redness, weeping, and sometimes, by the formation of yellow crusts - cause eczema to spread more quickly, and make healing difficult. They usually require treatment with antibiotics.
Inflamed or cracked skin also facilitates the spread of the herpes virus. Herpes usually affects the face and is characterised by small blisters filled with clear fluid that burst after a short period of time and leave behind crusts. Skin infected with herpes may also feel sore and the virus also results in a fever and tiredness. If you have herpes, it is important to see a doctor.
Lastly, while scratching is a natural reaction to itching, it is essential to avoid this as it can make eczema worse and lead to complications.
How Is Eczema Diagnosed?
Eczema is diagnosed by doing a physical exam that rules out other possible conditions like psoriasis. It is sometimes confused with seborrheic dermatitis, particularly in infants. Seborrheic dermatitis however, rarely tends to itch and generally clears up on its own after a few weeks or months.
For allergic eczema, an allergy test may be done via blood or skin pricks. Blood is tested for specific antibodies that the body produces in response to allergens. These however, are of limited use and aren’t a good idea unless you have good reason to believe that allergens may be affecting your eczema.
Treating And Preventing Eczema
While contact dermatitis can be avoided by avoiding the irritant responsible for flare-ups and taking an anti-histamine when flare-ups occur, eczema risk is otherwise mostly genetic and studies have shown that little can be done to prevent it. Some research however, suggests that breastfeeding children and consuming oral probiotics have a preventative effect. The WHO recommends that babies be breastfed for at least the first 6 months of their life as this does lower the risk of some infectious diseases.
While eczema can't always be prevented, regular care can successfully help manage the condition and keep rashes and itching away. The main treatment options include:
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Using emollient moisturisers that fill in the gaps between skin cells. They form a protective barrier that keeps skin from getting dehydrated, keeps germs and irritants out, and relieves itching.
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Using special cleansers that are gentler than soaps and don’t dry skin out or upset its pH.
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Steroid creams. These are typically only used for acute symptoms and should be treated as a last resort as they can create dependency and have long-term side effects like skin atrophy. When used, they should only be used for a short period of time.
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Pimecrolimus and tacrolimus. These are two other medications approved for the treatment of eczema over the age of two. They can also be topically applied and are typically used if steroids are not tolerated, or have proven ineffective.
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Other eczema treatment options include immunosuppressant medication, UV radiation, and wet wraps, which detailed in the image below. Our Concentrated Skin Repair Balm is a highly effective option for wet wrap therapy. Oral medications are typically only used if the eczema is severe and affects large areas of the body as they have more extensive side effects than topical treatments.
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People often also turn to herbal products or dietary supplements such as evening primrose oil, vitamin E and zinc, in search of a cure. Research however, hasn’t shown that these are effective. Other therapies exist but have yet been studied so are not currently recommended by doctors.
Recommended Products
Soothes and moisturise dry, eczema-prone skin, helps relieve skin allergies and irritation from environmental stressors. Formulated with cocoa butter, almond oil and coconut oil that form a protective lipid layer over the skin and help skin rebuild its defences.
Sea buckthorn oil has recently begun to be studied as a treatment for eczema and dermatitis. Mouse models have demonstrated that it is successfully able to alleviate dermatitis sores. It contains the highest found in nature of palmitoleic (omega-7) acid. Palmitoleic acid is anti-inflammatory and protects cells against oxidative stress. It is also highly beneficial for skin dryness, and atopic dermatitis, or eczema, among other things.
You can learn more about sea buckthorn oil and its benefits here.
